Search results

This paper aims to examine three recent papers on discrimination and exclusion that happen on a day-to-day basis in social interactions, known as micro-aggressions.

The author searched for recent papers on discrimination in the databases Psyc INFO and ASSIA. Three papers were selected addressing a common theme published within the past 24 months.

All three papers concern a US context. The first reports experiences of women with physical disabilities in relation to micro-aggressions. Based on focus groups with 30 women, micro-aggressions appear to be common and some cause considerable distress. The second paper reports experiences of 65 mental health peer support workers in a range of mental health services and finds micro-aggressions common for them too. The third paper goes beyond occurrence and type of micro-aggressions. Based on existing research, it proposes how members of marginalised racial groups can tackle micro-aggressions, whether they are the target, an ally or a bystander.

These papers show clear examples of micro-aggressions, making them easier to see. While the first two papers are each the first to document micro-aggressions for specific marginalised groups, the third paper is the first to bring together practical ways to tackle micro-aggressions in day-to-day life. There is potential for this to help bring about increased social inclusion and equity for a range of marginalised groups, and for a resultant benefit in the mental and physical well-being of many people.

This paper aims to highlight emerging research relating to the need to recognise and address trauma in mental health service users.

The author searched for papers on trauma-informed care, published in the past two years.

One paper reports ideas of service users and family members for trauma-informed mental health services. A second paper describes an online survey seeking agreement between staff and service users of early intervention services for psychosis about practices of trauma-informed care. Both papers feature themes about safety and staff having training and support for asking about and responding to trauma. A third paper reports on specific therapies for trauma with people who experience psychosis. It found some evidence for talking therapies but noted that people with a psychosis diagnosis are rarely offered such therapies.

These papers highlight an emerging consensus about essential components of trauma-informed care and the need for staff training and support to realise it. The exclusion of people with a psychosis diagnosis from specific trauma therapies might begin to be addressed if services were more able to recognise trauma. There is some evidence that talking therapies for childhood trauma can be helpful for people who have a psychosis diagnosis. However, evidence reviews should be broadened to include a range of distressing experiences recognised to follow childhood trauma irrespective of whether the person has a psychosis diagnosis.

The purpose of this paper is to explore the contents of the 2021 UK document called Commission on Race and Ethnic Disparities: The Report, convey some of its key messages and understand why it sparked controversy when its publication was announced.

The author read the 258-page report, made notes, looked up some of the papers and documents to which it refers to get a more complete understanding and conducted her own limited searches on some topics. The author sought comments on an early draft of the article.

After reading The Report and other relevant documents, the author feels that she has gained new insights into some challenges and opportunities facing members of different ethnic groups in the UK. However, the author felt that The Report plays down some realities of racism and its effects.

This is one viewpoint on The Report and is original. The Report looks at the circumstances of a range of specific ethnic groups in the UK. Its argument for greater interest and focus on these different experiences rather than thinking of all non-White groups as a single mass seems valuable. It also enables an understanding of some things that people can achieve in the face of adversity. However, the author hopes there is also value in my effort to understand why some aspects of The Report have been seen as controversial.

This paper aims to summarise key messages from a major evidence review of health inequality in England since 2010 – “the Marmot Review 10 Years on”.

Alongside “the Marmot Review 10 Years on”, which came out in February 2020, the author accessed the original Marmot review published in 2010, a 2020 article by Marmot, and Marmot’s online talk to the Royal Society of Physicians Edinburgh on 2nd of July 2020. The author drew out key messages from these sources.

Although many local authorities have taken up the 2010 Marmot review recommendations, they have been working against budget cuts under the system known as austerity. This has reduced funding to already deprived areas and probably explains worsened health inequality in England compared to other European countries. There are examples of successful local partnerships that have improved lives, but they rely on temporary charity funding. Health services can work for change locally, but central government policies must help. This has become even more urgent since the pandemic.

The original Marmot review and “the Marmot Review 10 Years on” are major evidence-based examinations of what causes and maintains health inequality, both physical and mental, and how this situation might be improved. It is impossible to study them and still believe that health is just about lifestyle choices. People need real options to choose from, and this is only possible if they live in places designed for human thriving from childhood to old age. As a nation, England can move towards this goal rather than further away from it. These reports show the way.

Humans have close relationships with animals for companionship and in working roles. The purpose of this paper is to discuss recent papers on pets and dog-assisted interventions, and relates their findings to social inclusion.

A search was carried out for recent papers on pets, animal-assisted therapy and social inclusion/exclusion.

One paper discusses theories (often lacking in studies of animal-assisted therapy) of why animals may be good for human health and development. A recent review shows evidence that family pet ownership may aid children’s well-being, learning and social development, but too few studies have followed children over time in pet and non-pet households. Studies of dog-assisted interventions show stress-reduction, which in turn may explain why therapy for mental health in young people and adults was more effective with a dog than without. Social inclusion is hinted at but not measured directly, yet dog-assisted therapy might be helpful in this regard.

All the papers discussed in detail here represent up-to-date understanding in this area of knowledge. Benefits of human-animal bonds, especially with dogs, appear to be well-supported by biological as well as observational and self-report evidence. More research is needed on how much these attachments may assist social relating and relationships with other people, and social inclusion.

The purpose of this paper is to highlight possible implications of therapists’ working conditions on social inclusion of service users.

A search was carried out for recent papers on cognitive behaviour therapy (CBT) therapists.

One study highlighted that over half of their sample of 201 UK therapists in Improving Access to Psychological Therapy (IAPT) services reported burnout. In a second study, in interviews with ten IAPT workers in inner London services, therapists said they had to fight for extra time to adapt CBT for people who had learning disabilities, and the additional stress made them feel less positive about working with these clients. A third study, on therapists working with people with multiple sclerosis, highlights the importance of adapting CBT for people with physical conditions.

Taken together, these three papers highlight concerning implications of current working conditions for many therapists working in IAPT services. They highlight that sources of stress include services’ rigid focus on targets and inability to make expected adjustments. With regard to the UK, this may be due to the current national service model, but it has implications for the social inclusion of some service users.

The purpose of this paper is to highlight how mental health recovery may involve family members and supporting the needs of parents who become mental health service users. Policies now recognise the importance of family but how much are they implemented?

A search was carried out for recent papers (past 12 months) on mental health services and the family.

Two papers summarise recent research on family involvement in mental health services. As well as highlighting what prevents families being involved in mental health services and care planning, they discuss what works and some challenges of involvement. A third paper highlights how parents who become service users can have their parenting needs supported as part of their recovery.

All three papers highlight recent developments in relation to the family and recovery. Despite policies about family involvement, there is a need for organisational change to fully incorporate the social nature of mental health and recovery. The papers suggest ways forward based on examples of what works.

Previous research suggests that service user and carer involvement (SUCI) in clinical psychology training may have an impact. The purpose of this study was to develop a validated questionnaire to enable trainee clinical psychologists to rate this.

A collaborative project was carried out with service users and carers and trainee clinical psychologists. The principles of questionnaire design were followed. The authors developed and validated a trainee self-report questionnaire, based on focus groups and relevant literature indicating potential impacts of involvement on practice. A draft 60-item version was piloted with 15 trainee clinical psychologists. Then, 133 trainees from 22 UK clinical psychology courses completed it (estimated response rate of 13.2%). The sample was representative of UK trainees in gender and ethnicity, but slightly older.

The principal component analysis produced a 36-item questionnaire with four factors: human communication, carer perspectives, empathy and challenging/changing. The questionnaire showed good internal consistency and test-retest reliability. Stakeholder consultation suggested face and content validity and there was some indication of construct validity.

The project has resulted in a usable co-produced questionnaire, which is now available to clinical psychology courses to assess the self-reported impact of SUCI in training, and which may also be used in future research.

Group art therapy involves art-making, which has been used throughout human history to symbolise struggle and transformation with group support. The purpose of this paper is to discuss two recent papers on how and why group art therapy may be helpful.

A search was carried out to find recent papers on group art therapy, with a focus on how and why it may be helpful.

One paper reported on 119 accounts of why group art therapy may be helpful. Five things seemed specific to group art therapy: using artworks to express experiences symbolically, connect with others, place confusing feelings outside oneself, and be playful, and following a set routine with others. The other paper reported in detail on group art therapy sessions with people who had a diagnosis of borderline personality disorder. Group interaction became most supportive when the art therapist clearly focused on people’s thoughts and feelings about artworks made by group members.

It has been unclear how group art therapy may help people. Understanding this means researchers can do more rigorous research on it. The two papers discussed represent probably the largest synthesis of different sources on how group art therapy might work, and the most detailed observation of what happens in practice. Both papers suggest group art therapy uses art to symbolise struggle and transformation with support from others, thus normalising this process and including those going through it rather than marginalising them. Parallels can be drawn with older healing rituals, in which crisis and struggle were viewed as normal.

This paper discusses two recent studies of mental health professionals who have experience of mental distress, one in the USA and one in Australia. The purpose of this paper is to highlight different experiences, first of largely concealing their experience, and second of disclosing and using it.

The Australian study examined the barriers experienced by mental health professionals, including trainees, in relation to seeking help. The USA study reported on a sample of mental health professionals who were doing well, including leaders of services, despite current or past mental distress.

Both studies included more psychologists than other mental health professionals. Australian mental health professionals reported similar fears and barriers to those found in other studies, in addition to concern about their colleagues’ duty to report impairment to the regulating body. Professionals in the USA-based study were described as potentially helpful in reducing stigma about mental distress because their achievements demonstrated that recovery is possible. However, many of them were also cautious about who they disclosed to, and wanted further reduction in stigma and discrimination.

The Australian study highlighted specifically that the requirement to report impairment to the regulator deterred people from disclosing distress at work, making it less likely that they would get help. The USA-based study was ground-breaking in documenting achievements of a substantial sample of mental health professionals with experience of mental distress. Potentially more professionals being “out and proud” might help increase recovery and social inclusion for service users more generally.